CMS Formulary

Displaying 137871-137880 of 1611142 results.
ID: 137871
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988399
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137872
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137873
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137874
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137875
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137876
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137877
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137878
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137879
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137880
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0